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DRUG INTERACTIONS

Influence of Coadministration on the Pharmacokinetics of Azimilide Dihydrochloride and Digoxin

Roger D. Toothaker, PhD, Alfred E. Corey, BS, Suzanne N. Valentine, MS, Jeff R. Agnew, MA, Nikhil Parekh, PhD, Werner Moehrke, PhD, Gary A. Thompson, PhD and James H. Powell, MD

From Procter & Gamble Pharmaceuticals, Health Care Research Center, Mason, Ohio. Dr Toothaker is currently at Akros Pharma Inc, Princeton, New Jersey; Mr Corey is currently at Human Genome Sciences, Inc, Rockville, Maryland; Ms Valentine is currently at DemandTec, Inc, San Francisco, California; and Dr Parekh is currently at Wyeth Consumer Healthcare, Richmond, Virginia.

The influence of coadministration on digoxin and azimilide pharmacokinetics/pharmacodynamics was assessed in a randomized, 3-way crossover study in 18 healthy men. Serial blood and urine samples were obtained for azimilide and digoxin quantitation. Treatment effects on pharmacokinetics were assessed using analysis of variance. The relationship between azimilide blood concentrations and QTc prolongation was characterized by an Emax model. Effects of coadministration on pharmacodynamics were assessed using a mechanistic-based inhibition model. Azimilide pharmacokinetics was unaffected by digoxin, except for a 36% increase in CLr (P = .0325), with no change in CLo. Digoxin pharmacokinetics was unaffected by azimilide, except for a 21% increase in Cmax (P = .0176) and a 10% increase in AUC{tau} (P = .0121). Digoxin coadministration increased the apparent EC50 with no effect on Emax, consistent with competitive inhibition (Ki = 0.899 ng/mL). The pharmacokinetic and pharmacodynamic changes observed upon coadministration were small and are not expected to be clinically important.

Key Words: Azimilide • digoxin • pharmacokinetics/pharmacodynamics • QTc • drug interaction

Address for reprints: Gary A. Thompson, PhD, Clinical Pharmacology and Pharmacokinetics, Procter & Gamble Pharmaceuticals, Health Care Research Center, 8700 Mason-Montgomery Road, Mason, OH 45040-9462.


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